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Annie Coppel, Implementation Consultant – North West 15 October 2014 What is NICE? The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for driving improvement and excellence in the health and social care system. New image London Office Our role • Improve outcomes for people using the NHS, public health and social care services • Help resolve uncertainty about best quality care and what represents value for money – identify good care and practice using the best available evidence – produce guidance and advice – support practitioners, providers and commissioners to use Guidelines A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Evidence Research studies - experimental and observational, quantitative and qualitative, process evaluations, descriptions of experience, case studies Guidelines NICE guidelines • Guidelines – – – – – Health Public health Social care Medicines practice Staffing • Health Technologies – – – – “NICE guidance sets the standards for high quality healthcare and encourages healthy living. Our guidance can be used by the NHS, local authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing” Technology appraisals (medicines) Interventional procedures guidance Medical technologies guidance (devices and some diagnostics) Diagnostic guidance Clinical topics Clinical guidelines set out the appropriate clinical care for patients with a specific disease or condition receiving care under the NHS. For example, dementia, autism, pressure ulcers, long term conditions such as diabetes, COPD etc • What works and what is value for money • Provide recommendations, based on evidence, on how to best identify, refer, diagnose, treat and manage patients Public health topics To promote good health and to prevent ill health - for people working in the NHS, local authorities and the wider public and voluntary sector. Examples of published guidelines: • Preventing the uptake of smoking by children and young people • Social and emotional wellbeing - early years • Domestic violence and abuse - how services can respond effectively • Obesity - working with local communities. • Contraceptive services with a focus on young people up to the age of 25. • Managing overweight and obesity in adults – lifestyle weight management services Social care topics Topic Guidelines Health and wellbeing of looked after children Published Supporting people to live well with dementia Published Autism in children and adults Published Mental wellbeing of older people in residential care Published Managing medicines in care homes Published Challenging behaviour in people with learning disability May 2015 Home care July 2015 Older people with multiple long-term conditions Sept 2015 Children’s attachment Oct 2015 Transition between health and social care Nov 2015 Transition from children’s to adults’ services Mar 2016 Child abuse and neglect May 2016 Mental health problems in people with learning disability Oct 2016 Our position in the social care sector Evidence, Guidance, Standards. Medicines practice How do we develop guidelines and who is involved Core principles and process for NICE guidance • Based on the best evidence available • Expert input • Patient, service user and carer involvement • Independent advisory committees • Genuine consultation • Regular review Topic referral Scoping Development Consultation Validation • Open and transparent process Publication GDG Who is involved in developing guidelines? GDG GDG GDG NCC Cancer GDG GP NCC Mental Health GDG GDG GDG GDG GDG GDG GDG NCC Women & Children’s GDG NICE Guidelines Team GDG GDG GDG GDG NCC Social Care GDG GDG GDG GDG GDG GDG GDG GDG GDG GDG National Clinical Guidelines Centre Acute and Chronic Conditions GDG GDG GDG GDG GDG GDG GDG Get involved with NICE Comment on draft guidance and standards All draft guidance and quality standards are consulted on prior to final publication. Register as a stakeholder to comment. Join a working committee Contribute to the production of guidance and quality standards. Vacancies are advertised on our website. Become a NICE Fellow or NICE Scholar Join us for a fixed period, for a day or more each month, to share your expertise, enthuse your colleagues or work upon an agreed research project of mutual interest. In return benefit from NICE’s expertise, mentorship and support. Getting involved with NICE encourages local engagement with relevant topics, fosters a culture of using evidence based guidance, and supports individual professional development. www.nice.org.uk/getinvolved Practical support for use Managing medicines in care homes NICE resources to support implementation Local Government Briefings • Concise information on cost-effective and evidence-based solutions for local government, public health and social care • For local authorities and their partner organisations in the health and voluntary sectors • Demonstrate potential role of NICE evidence and guidance as the basis of solutions to public health issues and problems at local level • Introduction • Key messages • What can local authorities achieve • What is effective • Examples of good practice • Developing an action plan • Costs and savings • Background to recommendations • Support • Other useful resources • Derived from existing guidance • Web-based with links to other sources of information. Also printable www.nice.org.uk/lgb Published 1. Tobacco 2. Workplace health 3. Physical activity 4. Health inequalities and population health 5. NICE guidance and Public Health Outcomes 6. Alcohol 7. Behaviour change 8. Walking and cycling 9. Obesity 10. Tuberculosis in vulnerable groups 11. Social and emotional wellbeing for children and young people 12. Judging whether public health interventions offer value for money 13. BMI thresholds to help prevent illness in black, Asian and minority ethnic groups 14. Improving access to health and care services for those not routinely using them 15. Encouraging NHS Health Checks and supporting people to reduce risk factors 16. Community engagement to improve health 17. Contraceptive services 18. Tackling drug use 19. Looked after children and young people 20. Domestic violence and abuse: how services can respond effectively NICE Savings and Productivity and Local Practice Collections A data base of shared learning examples. Moving on, The Lunch Club experience Description: Making a choice about when to move into a dementia care home can be a challenging, frustrating and frightening prospect for many older people. Opening our care home up to the community for lunch club assisting with dispelling myths of care homes, helping with a smooth dignified transition into care. Organisation: The Abbeyfield Society Guidance: QS30 - Supporting people to live well with dementia Implementing a policy for identifying and managing malnutrition in Care Homes Description: Implementing NICE Clinical Guideline 32 Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. By supporting staff in care homes we achieved improvements in nutritional management of patients and the reduction in the number of Health Care Professionals consultations for these patients. Organisation: City Healthcare Partnership CIC An ongoing implementation - reducing pressure ulcer prevalence in Birmingham Nursing Homes Description: An increasing prevalence of Pressure Ulcers in Birmingham Nursing Homes was halved by the implementation of a regular Pressure Ulcer Audit Organisation: Birmingham Community Healthcare Guidance: CG29 - Pressure Ulcers Management Go to the Into practice tab on the homepage to find the shared learning link Quality Standards – for quality improvement Guidelines and quality standards A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Evidence Guidelines Research studies - experimental and observational, quantitative and qualitative, process evaluations, descriptions of experience, case studies Quality Standards A prioritised set of statements designed to drive and measure quality improvement. A quality standard Supporting people to live well with dementia Quality statement 4: leisure activity • Aimed at care providers and carers. • Focus on key message from each quality statement • Links to key resources, and practical tools • Co-produced by Collaborating Centre for Social Care and key people in the social care sector Help to identify local priorities for quality improvement NICE quality standards can highlight key areas for improvement. An initial assessment of each statement within the quality standard should help you understand: • whether the statement is relevant to the organisation • how the current service compares to the statement • source of information to evidence this • what actions/resources would be required to improve the service so that it meets the quality standard statement • an initial assessment of risk associated with not making these improvements Locally prioritised quality improvement An assessment of how the service compares to the quality standard statements: • Can provide assurance • A positive assessment could be included in the organisation’s quality profile • An assessment indicating areas requiring quality improvement can: – inform local quality improvement work/programme planning – support discussions with commissioners • Inform the organisation’s audit programme (by identifying priority areas for audit) and business planning • Inform local risk management How can quality standards be used ? “As a provider of care services, I can use NICE guidance and quality standards to ensure, and therefore demonstrate, that I provide high quality care, based on the best available evidence.” "As a user of care services, they support me in my choices about who provides care for me, and in knowing what to expect from a good quality care service." "Commissioning services using NICE quality standards allows me to meet my duties as a local authority commissioner to promote integration of health and social care, and support me in ensuring the services I commission are high quality, and value for money” Supporting quality improvement Fundamental CQC Registration requirements NICE quality standards Proportion of services Inadequate Requires Improvement Good Standard of services Outstanding ‘Caring for our future: reforming care and support’ ‘By creating a library of social care quality standards we will provide commissioners and providers with evidence-based descriptions of what good care and support should look like. This will also help people using care and support, carers and families to understand what they should expect.’ and ‘NICE and the Care Quality Commission will work together to ensure that related standards (whether quality or regulatory) are complementary.’ NICE and the CQC A fresh start for the regulation and inspection of adult social care NICE QS relate to good and outstanding ratings, and have been used by CQC in developing their forthcoming framework. • Web based guide to help health & social care organisations use NICE guidance & quality standards to achieve high quality care in local settings • Suggests what an organisation can put in place and what staff can do to use NICE guidance & quality standards to improve outcomes & get the best value for money . • Includes helpful tips, links to other resources and shared learning examples of ways other people have used NICE guidance & standards • For commissioners, providers, quality improvement specialists, clinical governance or NICE leads, anyone implementing one specific piece of guidance, anyone planning or scrutinising care services. • Guide isn’t intended to be prescriptive or place limitations on what you might choose to do – it’s a good starting point! www.nice.org.uk/intopracticeguide Find relevant guidelines and standards Keeping up to date • Sign up for the NICE News • Log on to the website and register your details at www.nice.org.uk • Register as a Stakeholder for Social Care Guidance and Quality Standards: [email protected] • Email: [email protected] Discussion • Are you already using any NICE resources? Which and how? • Identify 3 ways in which using NICE resources can support your work? • What will you do as a result of learning today?